Pharmacy role in the proMotion of continencE (PRIME): a co-production study to develop a pharmacy bladder and bowel service

<title>Abstract</title> <bold>Background</bold> Urinary and faecal incontinence affects millions. Community pharmacies provide local community healthcare highlighting opportunity for innovation in continence promotion. The Pharmacy Role In the proMotion of continencE (PRIME) study was conducted to investigate development of a Pharmacy Bladder and Bowel Service (PBBS) incorporating key stakeholder engagement. <bold>Methods</bold> A UK online survey of community pharmacy staff identified current practice, and barriers and facilitators to PBBS development. Findings from earlier PRIME sub-studies: systematic literature review and qualitative interviews were incorporated into an evidence brief alongside the survey findings. This evidence informed key stakeholder participant discussions at two workshops using co-production methodology. <bold>Results</bold> Twenty-nine community pharmacy participants completed the survey reporting some provision of lifestyle advice in practice with clear scope for expansion. Sixteen participants including Community Pharmacists, Bladder and Bowel Service staff, Service users and healthcare commissioners participated in workshops. A protocolised service specification was derived detailing underpinning requirements and scope of service. Record sharing, advances in training, and reimbursement are required to enable the PBBS to be viable for community pharmacy provision. Acknowledged limitations are the pressures and relatively novel nature of pharmacy research which presents challenge in promoting participation. <bold>Conclusions</bold> This is the first evidence-based PBBS service specification, developed to inform future practice. An evaluation of implementation along with clinical and cost-effectiveness will be undertaken to inform optimised uptake. The PBBS provides potential for early identification, promotion of continence health, and self-help activation in community settings.